One hundred and nineteen patients with endoscopically confirmed prepyloric (n = 59) or duodenal (n = 60)
ulcer were stratified for
ulcer location before entering a randomized double-blind trial comparing
ranitidine (150 mg twice daily) and a potent liquid
antacid (
Novaluzid; 10 ml seven times daily, with a neutralizing capacity of 600 mmol H+). Fifty-four patients with prepyloric (26 receiving
ranitidine) and 53 patients with
duodenal ulcer (28 receiving
ranitidine) completed the trial in accordance with the protocol. The 4 and 6 weeks' healing rates for prepyloric
ulcers were 54%, 68%, and 61%, versus 69%, 79%, and 74% for the
ranitidine, the
antacid, and whole groups, respectively. For
duodenal ulcers these figures were 89%, 84%, and 87%, versus 100%, 96%, and 98% for the
ranitidine,
antacid, and whole groups, respectively. Differences in healing rates between treatments were statistically insignificant within strata for
ulcer type, but healing rates for prepyloric
ulcers were significantly lower than for
duodenal ulcers (p less than 0.002). A significant early
pain relief was found in all groups, and side effects, including diarrhoea, were rare. In conclusion, these two
ulcer treatment modalities appear to be equally effective in the short term. In addition, the data emphasize the need for proper stratification of prepyloric and
duodenal ulcers in clinical trials of
ulcer healing.